A massive framework of rust-brown girders stands right off I-71 and Pearl Road, in Middleburg Heights. Cranes lift materials to workmen adding on to what will eventually be a $23 million dollar health center for MetroHealth. Dr. Bill Lewis leads the expanding health system’s market development campaign.

“This is a 57,000 square foot facility, which is really to bring about 90 percent of what people need and from a medical care standpoint, to the southwest corner of Cuyahoga County," says Lewis. "We’re going to have a large primary care facility there, we’re going to have a large amount of imaging, stress testing, and physical therapy there. The goal is to have vast majority of other specialties that patients will need to be provided in the community rather than in the central hospital area.”

An estimated 60,000 patients are expected to visit the new MetroHealth facility in its first year alone, after it opens in 2013.

But just a couple miles to the north, construction project is underway. Right off of I-71 and Bagley Road, crews are working on Southwest General Hospital’s $128 million expansion. It’s slated for completion in October 2014. It will feature 96 private patient rooms, a 24-bed intensive care floor, and a two-story parking garage.

Thomas Selden, CEO of Southwest General, is well aware of the growing rivalry in this corner of the county.

“Metro(Health) is a new competitor in our service area, and they have announced that they’re looking for ambulatory sites, where they can find paying patients to help offset the fact they have a large number of uninsured patients," says Selden. "The site they’re building…every service they’ll have in there, will be a duplication of services we already provide here. And so it’ll increase the level of competition.”

So just what makes this part of Cuyahoga County so tantalizing for health industry rivals? Ziona Austrian, Director of the Center for Economic Development at Cleveland State, has looked at the southwest corner containing Middleburg Heights, Berea, and Strongsville. She says there are several factors.

“Between 2000 and 2010, population there increased by 2 percent," begins Austrian. "Maybe that doesn’t sound as a large increase, but the Cuyahoga County population declined by over 8 percent. Also the median household income of this three cities is growing, and it’s relatively high. Again compared to the county’s as whole.”

Austrian also says that affluent, growing population is also aging, which means increased need for health services. This all makes for a relatively fresh market for health providers, who are all eager to shore up their bottom line with privately insured patients.

As for the biggest player in the region, the Cleveland Clinic has largely downplayed any notions of competition. But it’s expanding services at a busy health center in Strongsville, and its newest rehab clinic in Middleburg Heights is now twice the size of one it occupied in Parma until a year and a half ago.

Dr. Tricia Martin, Manager of Satellite Services, says it’s to meet the growing needs of families, including many who’ve stayed on as clients from its Parma years.

“We have a waiting list of over 60 children right now, and we’ve hired 4 or 5 staff members in the past 6 months," Martin says. "We went from six patients back in 1999 to 310 patients that are being served now. And we’ve more than doubled the visits in the past 5 years.”

As these new facilities and expansions begin to come on line next year, one other thing is just about certain: locals will be afflicted with a number of aggressive marketing campaigns aimed at getting as many patients signed on with this provider or that provider as possible…before the dust settles.